Understanding Cognitive Behavioral Therapy (CBT)
Cognitive behavioral therapy (CBT) is a therapy or counselling modality that was founded in the 1960s and which has multiple applications.
With regard to addiction counselling, cognitive behavioral therapy helps people address problematic thoughts and feelings towards alcohol or their substance of choice.
CBT can be extremely beneficial for those at all stages of recovery as it teaches individuals to find connections between their thoughts, feelings, and actions and increase awareness of how these things impact recovery.
Alongside addiction, CBT can also be used to treat some common co-occurring disorders such as:
- Attention Deficit Disorder (ADD)
- Bipolar Disorder
- Obsessive Compulsive Disorder (OCD)
- Eating Disorders
- Post-Traumatic Stress Disorder (PTSD)
How Does Cognitive Behavioral Therapy Work?
Cognitive behavioral therapy shows that many harmful actions and emotions are not logical or rational. These feelings and behaviors may come from past experiences or environmental factors.
When an addicted person understands why they feel or act a certain way — and how those feelings and actions lead to substance use — they are better equipped to overcome their addiction.
Psychologists who utilize cognitive behavioral modalities in their practice can help recovering addicts identify their negative “automatic thoughts.” An automatic thought is based on impulse and often comes from misconceptions and internalized feelings of self-doubt and fear. Often, people try to self-medicate these painful thoughts and feelings by drinking them away or by abusing drugs.
By identifying coping strategies through professional therapy sessions, recovering addicts can reduce the pain caused by their automatic thoughts and they can then learn new, positive behaviours to replace their drug or alcohol use.
Cognitive Behavioral Therapy and Addiction Treatment
Automatic negative thoughts are often a root cause of depression and anxiety disorders, which are common co-occurring disorders with addiction. This means automatic thoughts can make someone more likely to abuse drugs and alcohol as well.
CBT helps patients overcome drug addiction and alcoholism by:
- Helping to dismiss the false beliefs and insecurities that lead to the alcoholic drinking or substance abuse
- Providing an individual with self-help tools to change their behaviours and moods
- Teaching more effective communication skills
Triggers are situations that “trigger” cravings throughout the day. Triggers can be people, places, things, situations or emotions. For example, visiting a place or person which the individual would normally associate with drinking or drugging. Or experiencing self-doubt which they would normally self-medicate away by drinking or using. Triggers are one of the biggest factors that keep many addicted people from getting sober. Cognitive behavioral therapy helps recovering addicts deal with triggers in 3 key ways:
1. RECOGNIZE: Identify the circumstances leading to drinking or using (the trigger).
2. AVOID: Remove yourself from the trigger situation whenever possible.
3. COPE: Use CBT techniques to address and alleviate the emotions and thoughts that lead from the trigger to the substance abuse.
One of the major plus points to CBT is that the techniques which are taught can be applied by the individual outside of the therapist’s office. Recovering addicts and alcoholics who are undergoing CBT are building a tool kit throughout their sessions which they can draw on when on their own, at home or whenever the circumstances require it.
Four Cognitive Behavioral Therapy Techniques
Cognitive behavioural therapists use specific exercises to help with recovery from addiction. Here are a few examples of CBT techniques which are often beneficial with regard to addiction and alcoholism recovery.
We all develop mental habits and certain ways of thinking over time. Some of these mental habits can lead us to consistently interpret situations in unhelpful ways, inconsistent with the facts of a situation, or leave out an important part of the picture. By utilizing a thought record or journal, recovering addicts examine automatic negative thoughts and look for objective evidence supporting and disproving those thoughts. They list evidence for and against their automatic thoughts to compare and contrast.
The goal of using a “thought record” is to help the person in recovery think more balanced and less harsh thoughts by critically evaluating what they are thinking.
Example: ‘My colleagues at work think I’m useless. I need to drink to feel better’. The therapist may ask what evidence there is of this and if the only feedback received is negative. The answer will often be no, because the colleagues make nice comments too. So the reframed thought becomes, “I receive constructive criticism from my colleagues at work. I don’t need alcohol to feel better about myself.’
These exercises contrast negative thoughts against positive ones to see which is more effective in changing behavior. Some people respond better to self-kindness and others to self-criticism. Behavioral experiments are all about figuring out what works best for the individual.
Example: ‘If I’m hard on myself after binge drinking, I’ll binge drink less’ vs. ‘If I talk kindly to myself after binge drinking, I’ll binge drink less.’
Once you have established whether you react more positively to encouragement or criticism it can be useful to let people know this – especially in a work place setting.
CBT tends to focus more on treating current symptoms rather than delving underneath the symptoms and looking at the trauma/past memories which might have caused the symptoms.
Example: A young man suffers from frequent panic attacks. Instead of trying to find the root cause of the panic itself, which can often be painful, CBT focuses on finding strategies to help manage the panic attacks when the occur.
Enjoyable (Treats) Activity Schedule
This technique involves making a weekly list of healthy, fun activities to break up daily routines. These tasks should be simple and easy to perform while encouraging positive emotions. Scheduling these pleasant activities helps reduce negative automatic thoughts and the subsequent need to use drugs or drink.
Example: Instead of using drugs or drinking on the job, an overworked lawyer relaxes at his desk for 15 minutes every day. He uses those 15 minutes to discover a new song from his favourite artist online or poem from a book of poetry.
One-on-One and a Flexible Approach
At The Lighthouse Bali, we offer CBT sessions to all clients and during these sessions, the client works with our trained counsellors on active exercises. While some people prefer a more traditional approach of talking and being heard, for some people CBT feels more productive.
All of our recovery programs are tailor-made to suit individual needs and personal responses. While some individuals will find a 12 step approach to recovery to be most beneficial to them, others may find CBT gives them results that they are more comfortable with. Others may benefit from a combination of both approaches. Our programs are one-on-one which means there is flexibility to adapt the modalities used by our professionals as the program progresses – something which group programs are unable to do.
Inpatient Care and Rehab
The Lighthouse Bali’s proven combination of an initial Primary Inpatient Program followed by Outpatient Care and Ongoing Therapy has helped alcohol addicts from around the world get their lives back on track. Through individually tailored treatment, professional therapy, medically assisted detox (if required), and compassionate support, you will be given the tools you need to ensure the best possible chances for long term recovery.
If you are concerned about yourself or a loved one, we urge you to reach out and contact us in confidence. Our private programs are tailor-made to suit individual needs and our doctorate level clinical staff have extensive experience in the field of addiction.
If you are not currently in Bali but would like to begin a recovery program immediately, contact us as we will be able to arrange a VISA for entry into Indonesia.
We also have online recovery options available which can be taken should you not wish to travel.
To talk to one of our team members, contact us on WhatsApp or by Phone. Alternatively, send us an email and we will either answer your questions in writing or call you back, according to your preference: Contact Us.
We understand how difficult it can be to reach out for help but it is the first step towards recovery and a happier, healthier way of living.